Drug-induced parkinsonism — SCE Neurology MCQ

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EasyMovement DisordersDrug-induced parkinsonismSCE Neurology

A 22-year-old woman presented with symmetric bradykinesia and rigidity after starting prochlorperazine. On examination, there was little rest tremor and gait was shuffling. Initial investigations showed: DaTSCAN was normal. What is the most likely diagnosis?

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Correct answer: B — Drug-induced parkinsonism

Drug-induced parkinsonism is the best answer because the vignette describes Drug-induced parkinsonism: dopamine receptor blockade with normal presynaptic dopaminergic imaging supports drug-induced parkinsonism. Corticobasal syndrome is plausible in a neighbouring presentation, but the chronology, examination or investigation pattern does not match the key discriminator here. Huntington's disease and Levodopa-induced dyskinesia are less appropriate because they would require different localisation, timing or test findings; Essential tremor would fit a different syndrome. Clinical pearl: idiopathic PD usually shows asymmetric dopaminergic deficit.

Reference: NICE NG71; Movement Disorder Society consensus criteria